Study first to connect use of EHR to better quality care

A new study links quality of care in physician office practices to the use of electronic health records, suggesting the significant investment in EHRs by the federal government and physicians will result in better care.

"Electronic Health Records and Ambulatory Quality of Care," published in the October issue of the Journal of General Internal Medicine, found that physicians using EHRs scored significantly higher on quality of care for four screening measures for diabetes, breast cancer, chlamydia and colorectal cancer. A composite score of all measures used in the study showed EHR use was associated with overall higher quality of care.

The study, conducted by researchers associated with Weill Cornell Medical College in Manhattan and NewYork-Presbyterian Hospital, examined data from 466 physicians in the community setting. The study used baseline year data assembled for the Hudson Valley Medical Home Project, a Hudson Valley Initiative project.

"Use of an EHR is a critical component of advanced primary care," A. John Blair III, MD, president of Taconic IPA and CEO of MedAllies, a health information services provider, said in a news release. "As with any health IT tool, an EHR is only part of the solution and must be integrated into the practice workflow and used by the care team to advance high-quality, patient-centered care." All the physicians in the Weill Cornell study were members of Taconic IPA, which boasts an 80% EHR adoption rate.

The Hudson Valley is one of seven regions recently selected for the Comprehensive Primary Care initiative, a four-year, multipayer initiative led by the Centers for Medicare & Medicaid Services’ Center for Medicare & Medicaid Innovation. Among the other selected regions is the state of New Jersey.

The initiative will test a service delivery model of comprehensive and accountable primary care. Among its emphases is meaningful use of health information technology to improve patient care. Physician practices and hospitals that meet specific federal standards for meaningful use are eligible to receive incentive payments from CMS.

Until recently, few studies could validate the clinical value of EHRs. "The previous studies on the effects of electronic health records in the outpatient setting have been mixed," the study’s lead investigator, Lisa M. Kern, associate professor of public health and medicine at Weill Cornell Medical College, said in the release. "This is one of the first studies to find a positive association between the use of EHRs and quality of care in a typical community-based setting, using an off-the-shelf electronic health record that has not been extensively tailored and refined. This increases the generalization of these findings."